Osteoporosis Flashcards
The skeleton is metabolically active. T or F?
true
Remodeling is necessary to maintain the structural ________ of the skeleton and to serve a metabolic function as a storehouse of __________and _________ for many functions
integrity; calcium and phosphorus
Bone mass peaks between _________ yrs.
-Why is this important?
25-35 yrs.
essentially you want to set your peak high before you reach the range
persistent metabolic disease is what condition?
osteoporosis
Osteoporosis is characterized by the following: (4)
low bone mass
impaired bone quality
decreased bone strength
enhanced risk of fractures
What is the primary/MOST common association of osteoporosis?
age-related changes, hormone and calcium levels and physical activity
What is the secondary etiology of osteoporosis?
consequence of disease (parathyroid) or medication
osteoporosis is ______% undiagnosed
MOST common _______ disease
70%
metabolic
What is osteopenia or low bone mass
precursor to osteoporosis
Osteoporosis risk factors:
-lower ________ levels such as _________ (females) and _______ (males)
-limits bone ______________
hormone; estrogen; testosterone
resorption
Osteoporosis can be genetically inherited? T or F
True
how much caffeine per day is recommended to limit osteoporosis from occurring?
< 3 cups (8 oz. in a cup) of caffience per day
What is a standard question to ask women (65≥) and males (≥70) yrs.
Dexa Scan
Pathogenesis of Osteoporosis:
-primarily a metabolic disorder as _____________ activity > ___________ activity
-secondarily an ____________disorder due to other conditions that limit calcium, estrogen, and testosterone
osteoclastic > osteoblastic
endocrine
Pathogenesis of Osteoporosis:
_________,__________, and _________ of vertebral body MOST often in lower thoracic and upper lumbar regions
wedging, compression, and fx
What are 3 common areas of fx
note - non traumatic > traumatic
femurs, ribs, radius
Osteoporosis is often symptomatic before fx occurs. T or F
false; asymptomatic
Observation/Risk Factors of Osteoporosis: (3)
FHP
Loss of height
Increased thoracic and lumbar kyphosis- fulcrums (even @ rest) or rounded slouched posture
Fx often occurs with a seemingly benign _______ activity
ex:
flexion
-bending; sneezing
Why would P! refer to flanks and abdominal region?
shared innervations
Osteoporosis S&S:
Fx S&S plus severe _________ P! between _______ and _________ spinal regions especially with ________,______ and __________stresses
back; mid thoracic and lumbar
flexion, compression, and valsalva
What would be expected scan findings for Osteoporosis:
ROM:
Resisted Tests:
Stress Test:
Neuro:
ROM: P! and limited primarily w/ flexion but possibly all directions
Resisted Tests: P! and weakness, primarily w/ flexion but possibly all directions
Stress: P! w/ compression likely relief with distx
P! w/ PA pressures
Neuro: MOST often negative
Osteoporosis Biomechanical Exam: Special Tests (2)
Percussion
Supine Sign (inability to lie flat due to P!)
Osteoporosis:
-If suspected Fx most likely _________referral
-If suspected neurological symptoms or inability to walk ________referral
urgent
emergency
PT Rx: Osteoporsois
-Even if an fx, it is usually ________ and able to tolerate Rx due to _________ so proceeded based on symptoms
-Positional and directional preference w/ education treatments, and activities – give examples
stable; ligamentous structure
directional preference: EXT
pt. edu: slip-on shoes, corset
bracing; assistive devices (cane/reacher)
PT Rx: MET focuses on osteoporosis
MT:
bone integrity (maintenance or improving density
balance
walking and resistance training
JM: be cautious with JM’s, particularly high grades if advanced level of disease or ≥ 3 mths of corticosteroid use
may utilize JM to normalize motions and stresses throughout the spine
The majority will heal after _____ to______ weeks of conservative treatment with a subsequent decline in P!
8-12 weeks
MD RX:
————- ————-:
good treatment for pts. with ______/______ P!
Percutaneous vertebroplasty
acute/subacute
*basically biological cement
what is osteomalacia?
bone softening without loss of bone mass or brittleness as with osteoporosis
osteomalacia Etiologic Factors:
insufficient intestinal calcium absorption due to lack of calcium or more likely low vit D.
Increased kidney phosphate loss
osteomalacia Risk Factors:
lack of dietary or sunlight Vit. D
Malabsorption conditions including age affect digestive and metabolic functions
Medications alter Vit. D, calcium, or phosphate
osteomalacia pathogenesis:
lack of ______ salts
structure _______ but still weakness in the bone w/possible fx
primarily affects _____ and _______
calcium
unchanged
vertebra and femur
osteomalacia S&S:
________and often ______ due to diffuse achiness and fatigue w, wt. loss
LBP and pelvic and LE P!, aggravated by __________
muscles _______ and polyneuropathy
difficult;delayed
weight bearing
weakness
osteomalacia had greater neuromuscular influences than osteoporosis. T or F
True
